Third Degree Tears After Epidural
Does an epidural increase the risk of a third degree tear, or does an epidural decrease the risk of a third degree tear?
Third degree tear epidural increases risk
A large amount of medical literature suggests that an epidural increases the risk of a third degree tear during a vaginal delivery.
Oxford University NHS Trusts suggest that an epidural will increase your risk by 2%. By comparison, the same leaflet states that an assisted birth carries the highest risk, increasing the chance of a third degree tear by 7%.
The reasons given in the medical literature is that the epidural numbs everything from the waist down. Consequently the mother cannot feel her perineum, and cannot control the final stage of pushing when the perineum needs to slowly stretch to accommodate the baby.
Additionally, the mother will be unable to move position and must deliver the baby while lying on her back. This can make a tear more likely. When an epidural is not performed, women are usually encourage to deliver on all fours.
Third degree tear epidural decreases risk
However, there have been some more recent studies that suggest an epidural does not increase the risk of a third degree tear. Some go even further to state that an epidural actually offers protection against tearing.
A study published in 2011 supported the hypothesis that 'epidural analgesia during labour may be protective against 3rd/4th degree perineal trauma' because it reduces the 'urge to push at the point of delivery'.
Therefore the evidence is conflicting and there are convincing arguments and data on both side of the debate. More research will be needed to better understand whether or not an epidural increase or decreases the risk of a 3rd degree tear.
Other factors that increase the risk of tearing
There are other factors that are known to increase the risk of a third degree tear, including:
- A large baby
- Induction of labour
- The baby is born 'back to back'
- First vaginal birth
- Long second stage of labour
- Shoulder dystocia
- Assisted delivery
Can medical negligence be to blame?
There are instances in which medical errors contribute towards a third degree tear. However, third degree tear claims usually arise because a third degree tear was not diagnosed or repaired properly. If this has happened to you, you could be entitled to claim compensation. Please get in touch with us for more information.
Please call us on 0800 234 3300 (or from a mobile 01275 334030) or complete our Online Enquiry Form.
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